Physician Coding Educator

Children's Healthcare of Atlanta

About The Position

The Physician Coding Educator provides education in coding and billing compliance to physicians, physician assistants, nurse practitioners, and clinical service auxiliary providers to improve the workflow and promote overall clinical documentation improvement. Creates communication of important coding and billing information for administrative and finance leaders as it relates to their areas. Assists in the development of evaluation and management and other billing code utilization reports for comparison to national and peer-to-peer data. Supports the improvement of overall coding and billing practices of the physician professional services. In addition, the Physician Coding Educator provides subject matter expertise related to documentation and coding requirements to support provider’s performance of appropriate and compliant charge capture for professional services. This individual develops and trains Children’s practitioners on educational content related to coding, documentation and charge capture while monitoring the ongoing coding and documentation needs of the organization and providing feedback to Children’s leadership. Collaboration with the Physician Leaders, Practice Leaders, Compliance, Legal and Finance on coding initiatives and goals is key.

Requirements

5 years of experience in teaching professional coding education and compliance documentation.
Advanced knowledge and experience in interpreting and applying federal/government regulations to ensure coding and documentation compliance
High school diploma or equivalent
Minimum of one of the following: Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), or Certified Coding Specialist – Physician-based (CCS-P)
Strong knowledge base in complete and accurate clinical documentation in all healthcare settings and for all healthcare disciplines
Strong knowledge base of the conventions, rules, and guidelines for multiple classification and reimbursement systems (e.g., ICD -10, diagnosis-related group, and all patient refined diagnosis-related group)
Demonstrated knowledge of medical terminology, anatomy and physiology, pharmacology, computers, and encoding software
Demonstrated strengths in teaching and presentation skills
Ability to work with physicians and senior leaders
Must be detail-oriented and have strong analytical, organizational and communication skills

Nice To Haves

Teaching or instructional design certificate

Responsibilities

Provides continuous education and updates to physicians, advanced practice providers, and practice leadership regarding coding and billing practices to meet regulatory requirements on local, state, federal and national level to capture appropriate revenue.
Provides appropriately messaged individual feedback and facilitates interventions to address educational gaps and manages all aspects of documentation and coding processes.
Develops and implements educational content in compliance with industry standards in collaboration with Leaders, Compliance, Legal and Providers using appropriate adult education principles and strategies. Develops content that can be used in alternative learning (blended and e-learning)
Works closely with internal or external vendors/departments to launch materials in live trainings and on a Web-Based platform, monitors and reports on practitioner participation in Web-Based and instructor-led training and monitors and reports on "measured" learning outcomes.
Collaborates with the Manager of Physician Documentation and Coding Education to develop strategy around design and delivery of all aspects of documentation and coding training and implements action plans for risk adjustment targets.
Provides input to Organization Leaders, to ensure accuracy of missed opportunity reports, complete coding reports, EPIC functionality and other identified reporting and data mining opportunities.
Educates physicians and key healthcare providers regarding clinical documentation improvement and the need for accurate and complete documentation in the health record, working alongside CHOA Internal Coding Audit and Coding Operations to ensure the accuracy and completeness of coding reviews for providers; coordinates review of any open issues and monitors until resolved.
Educates assigned new physicians and advanced practice providers on coding needs specific to their specialty as part of the onboarding experience.
Performs shadowing services for billing providers and administrative staff to gather information and provide constructive input to operations and the billing provider to become more efficient in daily workflow and accuracy in charge selection supported by their clinical documentation.
Monitors coding resources and payer updates for issues that impact professional billing and reports to manager and practice leaders.
Anticipates and articulates emerging organizational needs and identifies and implements strategies for organizational improvement around coding, documentation, and charge capture. Identifies "gaps" in current documentation and coding processes and collaborates on the revision of design and implementation through the reporting of a coding needs assessment.
Develops tools and training materials as assigned that will assist providers, practice management, and office staff to meet regulatory requirements and capture all appropriate revenue.
Analyzes billing and denial information, claim error, and other data for potential coding and billing opportunities. Summarizes and reports findings to manager and uses findings in educational trainings.
Understands post-billing review findings and assists in relaying constructive education for the purpose of improving deficiencies identified in the review.
Reviews and analyzes evaluation and management coding and other billing trend profiles to identify patterns that may provide clues requiring focus for further analysis, support, and/or education.
Reviews encounter forms, coding forms, or billing tool information at least annually, and recommends changes to codes and encounter form layout as necessary.